Provider Relations Consultant – Skilled Nursing Facilities

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<div class="isg-job-description“>The Provider Relations Consultant is responsible for the full range of provider relations and service interactions within UnitedHealth Group, including leading a team of Provider Engagement Representatives servicing contracted skilled nursing facilities, promoting the use of physician portal and future service enhancements, and training & development of external provider education programs. Provider Relations Consultants design and implement programs to build and nurture positive relationships between the health plan, providers (Skilled Nursing Facility, physician, hospital, ancillary, etc.), and practice managers. Responsibilities also include directing and implementing strategies relating to the development and management of a provider network, identifying gaps in network composition and services to assist the network contracting and development staff in prioritizing contracting needs, and may also be involved in identifying and remediating operational shortfalls.
Primary Responsibilities:

• Anticipate customer needs and proactively develop solutions to meet them
• Serve as a key resource on complex and / or critical issues
• Solve complex problems and develop innovative solutions
• Perform complex conceptual analyses
• Review work performed by others and provide recommendations for improvement
• Forecast and plan resource requirements
• Authorize deviations from standards
• May lead functional or segment teams or projects
• Provide explanations and information to others on the most complex issues
• Motivate and inspire other team members.

You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
 
Qualifications – Internal
Required Qualifications:

• High School Diploma/GED OR 4+ years experience working in a skilled/nursing facility
• 2+ years’ experience working in a skilled/nursing facility
• 2+ years of experience with Medicare and Medicaid regulations
• Current resident of the state of Texas and a valid TX driver license in good standing
• Intermediate level of knowledge of claims / systems processes, contracting and reimbursement methodologies
• Intermediate level of proficiency with MS Word, Excel, PowerPoint
• Ability to travel for the position up to 25% of the time

 
Preferred Qualifications:

• Undergraduate Degree
• Understanding of revenue cycle management in long term care

 

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